An 85-year-old person has a urinary tract infection. What clinical manifestation do you expect to see in this person?

Choice A reason: Increased permeability and leakage occur at an injury site due to histamine and cytokine release, causing endothelial gaps. This allows plasma and immune cells to enter tissues, promoting inflammation and edema, making this a correct vascular change.

Choice B reason: Blood vessels initially constrict to limit bleeding, then dilate to increase blood flow, delivering immune cells and nutrients. This biphasic response (constriction followed by dilation) is a hallmark of acute injury, making this a correct vascular change.

Choice C reason: Pallor occurs from initial vasoconstriction, reducing blood flow, followed by swelling from increased permeability and fluid leakage. These are typical injury responses, reflecting vascular and tissue changes, making this a correct observation.

Choice D reason: “None of the above” is incorrect, as increased permeability, biphasic vessel response, and pallor with swelling are well-documented vascular changes at injury sites. These align with the inflammatory process, making this an invalid choice.

Choice E reason: Tightening of capillary endothelial junctions does not occur during acute injury. Junctions loosen due to inflammatory mediators, increasing permeability, not tightening, which would limit leakage, making this an incorrect vascular change.

Choice A reason: Pyuria, urgency, and frequency are typical UTI symptoms, but elderly patients often present with atypical signs like confusion. Confusion is more prominent in this age group, so this is less specific and incorrect.

Choice B reason: Dysuria, frequency, and suprapubic pain are common UTI symptoms, but elderly patients may show confusion instead of classic signs. Confusion and frequency are more likely, so this is incorrect.

Choice C reason: In elderly patients (85 years), UTIs often cause confusion due to altered mental status, alongside frequency. Atypical symptoms like confusion are common, making this the correct manifestation for this age group.

Choice D reason: Hematuria and flank pain suggest complicated UTIs or kidney issues, not typical in elderly UTI presentation. Confusion and frequency are more expected, so this is incorrect.